How to repair EHRs? A healthcare IT manager has ideas
Amanda Hansen’s father suffered from diabetes for most of his life, until his death in March 2017. Like many patients, he had to collect his own medical records and carry a thick stack of paper from a provider to another to control their own healthcare journey.
Seeing the ongoing problems he was having managing his condition on a paper-based system spurred Hansen on to a passion for health informatics. She is now president of AdvancedMD, a software provider for medical practices.
The case for electronic health record systems is obvious, but there can be issues with implementation, data interoperability, and overall administrative burden on providers.
Hansen believes health informatics vendors have a responsibility to help vendors close the loop with patients — especially those with chronic conditions — by ensuring vendors are ordering the right labs and prescriptions and that patients feel involved and have the right questions to ask.
Hansen says she wants to fix EHRs, that’s why Health Informatics News sat down with her to discuss her thoughts on solutions, her dad’s experience, and the technologies that can best help chronic conditions.
Q. Your father’s health care experiences had a major impact on you. Please talk about his experiences and how they affected you.
A. Ever since my dad was a toddler, a big part of his life was managing his type 1 diabetes. As he aged into his 40s and 50s, it was a big part of my life and that of my mother too. He saw numerous specialists, had transplants, endured thousands of hours of dialysis, and suffered vision loss. We lost him at only 60 years old.
Although I remember so many wonderful things about my father, now, as a leader in health informatics, I look back on his medical background and lament the limitations of health care delivery at that time.
Unfortunately, chronic disease management predated electronic health records, and paper records brought a lot of baggage – literally. My mother and I took large binders with us to her appointments, filled with papers detailing her complex medical history.
Every specialist, doctor and surgeon would leaf through this past, bearing the real weight of our sadness and trauma. They had more and more questions, just trying to piece together the facts of the case like historians. I imagine how much easier and more streamlined our collective experience would have been if my father had had an electronic file with digital records.
As healthcare technologies have evolved, I am relieved that patients no longer have to carry filing cabinets and deal with the many hurdles created by paper records. For every solution we develop, for every interoperability problem we solve, we make healthcare transparent for providers and patients.
Episodes of care and chronic disease management tasks can be daunting. They shouldn’t be. We are committed to transforming healthcare so that the experience is seamless, unified and complete.
Q. You believe health informatics vendors have a responsibility to help vendors “close the loop” with patients. Please elaborate.
A. Although we have abandoned these paper burdens in favor of digitization, healthcare informatics providers still need to do more to ensure a closed-loop experience. Especially for chronic care and complex patients, it is essential that workflow processes help prevent gaps in comprehensive care, which expose patients to adverse outcomes.
It is also essential that laboratory and pharmacy functions are well integrated into patient management tools so that these elements are included for comprehensive, coordinated and efficient care management.
Today’s high-performance EHRs support providers and engage patients to facilitate access to the right patient at the right time with the right treatment. True interoperability between leading systems and providers helps clinicians guide patients with chronic conditions with minimal time and effort.
Automation is a big part of that. We use automated tools so providers can spend more time nurturing meaningful relationships with patients.
These relationships, while still grounded in human interaction, are enhanced by engaging patients in their own care. By staying in touch with patients often and via the method of their choice – SMS, call, email or portal, for example – communication and task execution happen on their terms.
By offering online messaging, appointment scheduling and reminders, bill payment, medical records and results retrieval, pre-arrival preparations for more streamlined check-in and similar functions, providers encourage patients to be engaged, adherent and proactive.
Guided by the right technology, chronic care management is a real team effort. As providers of health informatics, it is our responsibility to facilitate this engagement.
Q. You said you wanted to fix the DSEs. What is wrong with them and what do you think is the solution?
A. As any healthcare professional can attest, EHRs have advantages and disadvantages. In general, the problems can be solved and are far outweighed by the benefits of EHRs. What we’ve seen with technology is that some solutions are “cookie cutter” and can’t adapt to unique workflows, patient populations, or overall practice styles.
There are so many moving parts as well as legacy billing and practice management systems in place that many EHRs – as designed – fail to facilitate seamless functionality. They are also unable to provide a holistic picture of the entire patient experience.
For an optimized EHR, it really needs to provide clinicians with an immediate and quick idea of the patient’s complete medical history. When administrative overhead is minimized, clinicians can only devote their time and effort to providing high quality care to their patients.
Efficiency in care delivery – especially as the industry moves towards value-based care – requires customized and scalable technology, and some EHRs simply don’t fit the bill.
Health informatics providers maximize their impact in developing technologies that enable personalized and meaningful interactions with patients. EHRs not only provide an individual view of the patient, but they are also able to leverage greater amounts of data on treatment plans that help providers decide on optimal care pathways for better outcomes.
The industry needs to think about how EHR technology most effectively leverages data for the benefit of the patient. There is still work to be done. Digitization and integration will make it possible.
Q. Chronic diseases are of particular concern to you. What technologies can help providers better manage chronic conditions?
A. As I saw with my father, chronic disease management can be very complex and challenging for patients, their families, and providers. It is also very expensive.
The CDC reports that 90% of annual healthcare spending, totaling $3.8 trillion in the United States, is for people with chronic and mental health conditions. And poor patient care contributes to that cost: when conditions aren’t appropriately managed in a timely manner, bigger and more costly problems arise later.
For providers struggling to deliver excellent care in this tight reimbursement climate, efficiency is key. Many offices are struggling to manage clerical and administrative loads in the complex management of conditions, and burnout is currently high.
EHR technologies that seamlessly unite with practice management and patient engagement tools enable clinicians to consistently deliver high-quality care. When technologies are leveraged to encourage and maintain patient engagement in their own care, it shows in their outcomes as patients progress towards treatment goals, especially when linked to mode changes. lifestyle and medication management.
Healthcare IT leaders must continue to invest in technologies that guide effective chronic disease management. While today’s chronic patients are better off than those of decades past, the engaged patients of the future will benefit more from smarter, well-integrated technologies.